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s3 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name : Town of Chapel Hill Party/Vendor Contact Person : Chief of Police Chris Blue Contact <br /> Phone : 919 -96 &2760 Party/Vendor Address : 828 MLK Jr Blvd City Chapel Hill State : NC Zip : 27516 <br /> Department : Animal Services Amount : 108 , 732 Purpose : Animal Control Services Budget Code (s ) : 10215305 <br /> 489951 Vendor 9 64 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No ® Contract Type : (Check <br /> one) New ❑ Renewal ® Amendment ❑ Effective Date 07/01 /2019 Approved by Board Yes ❑ No ❑ <br /> Agenda Date : <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work <br /> on this project has not been initiated prior to execution of the agreement : <br /> Department Director ' s Signature Date : f <br /> Agreements for emergency services or repair are not subject to the above affirmation . If services related to dris <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that <br /> was addressed : <br /> Information Technologies <br /> (Applicable only to hardware/softvvare purchases or related services) This agreement has been reviewed and is <br /> approved as to information technology content and specifications : <br /> Office of the Chief Information Officer Date : <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards , specifications , and requirements : <br /> Office of the Risk Management Officer 6D Date . <br /> otoc <br /> Financial Services <br /> This instrument has been pre- audited in the ma r re ir by the Local Government Budget and Fiscal Control <br /> Act : <br /> Office of the Chief Financial Officer Date : 1 � Z <br /> Legal Services Services <br /> This agreement is approved as to legal form a suffic ' <br /> Office of the County Attorney Date : <br /> Clerk to the Board <br /> Received for record retention : <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion : smgersoll@orangecountync . gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts : <br /> Office of the Clerk to the Board Date . <br /> Rev 5 / 19 <br />